Impacto da análise do 'wavefront' na refratometria de pacientes com ceratocone

Ambrósio, Renato; Caldas, Diogo Leitão; Silva, Renata Siqueira da; Pimentel, Leonardo Nogueira; Valbon, Bruno de Freitas

doi:10.1590/s0034-72802011000100004

Cited by 4 publications

(1 citation statement)

References 52 publications

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“…Nas últimas décadas, surgiram estudos demonstrando bons resultados com uso de aparelhos com wavefront para fornecer a refração objetiva nesses casos, no entanto esses estudos não foram randomizados ou duplo-cegos, além do que, o alto custo dessa tecnologia afasta essa abordagem do dia a dia dos consultórios oftalmológicos no Brasil 8,9 .…”

Section: Discussionunclassified

Estimate of spherical power based on ocular biometrics data

Cunha¹,

Júnior²,

Marchezine³

et al. 2022

eOftalmo

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Propôs-se desenvolver uma fórmula baseada na ceratometria corneana e diâmetro anteroposterior do globo ocular para estimar a refração esférica objetiva, ou poder esférico estimado. Métodos: Estudo retrospectivo, transversal e observacional, selecionou prontuários de 150 pacientes míopes, consecutivos, atendidos no Oftalmocenter Santa Rosa -Cuiabá -MT, entre o período de 2017 a 2019. Coletou-se dados da idade, sexo, acuidade visual, refração com cicloplegia, e resultados da ceratometria e diâmetro anteroposterior. Utilizou-se a regressão linear múltipla para determinar os possíveis modelos. Resultados: Dos 150 prontuários, 100 olhos direitos continham todos os critérios de inclusão. A idade média foi de 17 ± 6,2 anos, sendo 49 do sexo masculino. A média e o DP da miopia, astigmatismo, K 1 , K 2 e diâmetro anteroposterior foram de -4

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Section: Discussionunclassified

Estimate of spherical power based on ocular biometrics data

Cunha¹,

Júnior²,

Marchezine³

et al. 2022

eOftalmo

View full text Add to dashboard Cite

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Multimodal diagnostics for keratoconus and ectatic corneal diseases: a paradigm shift

Ambrósio,

Salomão,

Barros

et al. 2023

Eye and Vis

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Different diagnostic approaches for ectatic corneal diseases (ECD) include screening, diagnosis confirmation, classification of the ECD type, severity staging, prognostic evaluation, and clinical follow-up. The comprehensive assessment must start with a directed clinical history. However, multimodal imaging tools, including Placido-disk topography, Scheimpflug three-dimensional (3D) tomography, corneal biomechanical evaluations, and layered (or segmental) tomography with epithelial thickness by optical coherence tomography (OCT), or digital very high-frequency ultrasound (dVHF-US) serve as fundamental complementary exams for measuring different characteristics of the cornea. Also, ocular wavefront analysis, axial length measurements, corneal specular or confocal microscopy, and genetic or molecular biology tests are relevant for clinical decisions. Artificial intelligence enhances interpretation and enables combining such a plethora of data, boosting accuracy and facilitating clinical decisions. The applications of diagnostic information for individualized treatments became relevant concerning the therapeutic refractive procedures that emerged as alternatives to keratoplasty. The first paradigm shift concerns the surgical management of patients with ECD with different techniques, such as crosslinking and intrastromal corneal ring segments. A second paradigm shift involved the quest for identifying patients at higher risk of progressive iatrogenic ectasia after elective refractive corrections on the cornea. Beyond augmenting the sensitivity to detect very mild (subclinical or fruste) forms of ECD, ectasia risk assessment evolved to characterize the inherent susceptibility for ectasia development and progression. Furthermore, ectasia risk is also related to environmental factors, including eye rubbing and the relational impact of the surgical procedure on the cornea.

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Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark

Kanellopoulos¹,

Asimellis²

2013

OPTH

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PurposeTo introduce a novel, noninvasive technique to determine the depth and extent of anterior corneal stroma changes induced by collagen cross-linking (CXL) using quantitative analysis of high-resolution anterior-segment optical coherence tomography (OCT) post-operative images.SettingPrivate clinical ophthalmology practice.Patients and methodsTwo groups of corneal cross-sectional images obtained with the OptoVue RTVue anterior-segment OCT system were studied: group A (control) consisted of unoperated, healthy corneas, with the exception of possible refractive errors. The second group consisted of keratoconic corneas with CXL that were previously operated on. The two groups were investigated for possible quantitative evidence of changes induced by the CXL, and specifically, the depth, horizontal extent, as well as the cross-sectional area of intrastromal hyper-reflective areas (defined in our study as the area consisting of pixels with luminosity greater than the mean +2 × standard deviation of the entire stromal cross section) within the corneal stroma.ResultsIn all images of the second group (keratoconus patients treated with CXL) there was evidence of intrastromal hyper-reflective areas. The hyper-reflective areas ranged from 0.2% to 8.8% of the cross-sectional area (mean ± standard deviation; 3.46% ± 1.92%). The extent of the horizontal hyper-reflective area ranged from 4.42% to 99.2% (56.2% ± 23.35%) of the cornea image, while the axial extent (the vertical extent in the image) ranged from 40.00% to 86.67% (70.98% ± 7.85%). There was significant statistical difference (P < 0.02) in these values compared to the control group, in which, by application of the same criteria, the same hyper-reflective area (owing to signal noise) ranged from 0.00% to 2.51% (0.74% ± 0.63%).ConclusionHerein, we introduce a novel, noninvasive, quantitative technique utilizing anterior segment OCT images to quantitatively assess the depth and cross-sectional area of CXL in the corneal stroma based on digital image analysis. Mean cross-sectional area showing evidence of CXL was 3.46% ± 1.92% of a 6 mm long segment.

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Impacto da análise do 'wavefront' na refratometria de pacientes com ceratocone

Cited by 4 publications

References 52 publications

Estimate of spherical power based on ocular biometrics data

Estimate of spherical power based on ocular biometrics data

Multimodal diagnostics for keratoconus and ectatic corneal diseases: a paradigm shift

Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark

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